本文關(guān)鍵詞： 高螺距 雙源CT 肺動脈造影 自然呼吸 輻射劑量 碘負荷　出處：《浙江大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 評價自然呼吸狀態(tài)下、高螺距雙源CT肺血管造影(CTPA)的成像質(zhì)量,探討該技術(shù)在可疑肺栓塞患者中應(yīng)用的可行性。 方法： 對110例臨床疑似肺動脈栓塞的患者采用第二代雙源CT行CT肺血管造影(CTPA),患者隨機分為2組：高螺距組(n=55)患者在自然呼吸狀態(tài)下行螺距(pitch)為3.0、管電壓100Kv、管電流100mAs的掃描,注射對比劑40ml。常規(guī)組(n=55)行常規(guī)CTPA檢查,螺距(pitch)為0.8、管電壓120Kv、管電流100mAs,注射對比劑80ml,深吸氣后屏氣掃描。統(tǒng)計比較兩組肺動脈主干、尖段(S1)和后基底段(S10)肺動脈的強化程度、圖像噪聲、信噪比(SNR)、 CT容積劑量指數(shù)(CTDIvol)、劑量長度乘積(DLP)、有效劑量(ED)及圖像的主觀質(zhì)量評級。采用SPSS19.0軟件,進行Student t檢驗、四格表卡方檢驗、非參數(shù)秩和檢驗、Kappa一致性檢驗進行統(tǒng)計學(xué)分析。 結(jié)果： 肺動脈主干平均CT值高螺距組(421±107)高于常規(guī)組(375±113)p0.05)；高螺距組SNRs1(41.63±9.26)和SNRs10(41.31±9.13)明顯高于常規(guī)組的平均SNRs1、 SNRs1o(33.24+10.23、35.20±11.11),兩組之間差異具有顯著統(tǒng)計學(xué)意義(p0.01)；平均圖像噪聲(10.05±1.53)、平均檢查時間(0.76±0.07)明顯低于常規(guī)組；高螺距組的平均輻射劑量CTDIvol、DLP及ED分別為2.88±0.44mGy、88±14mGy*cm和1.50±0.23mSv,均顯著低于常規(guī)組(5.61±0.98mGy、144±30mGy*cm和2.45±0.52mSv),兩組之間差異具有顯著統(tǒng)計學(xué)意義(p0.01)；高螺距組主觀圖像質(zhì)量評分高于常規(guī)組(p0.05)。高螺距組中,所有患者沒有出現(xiàn)呼吸及心臟運動偽影,沒有出現(xiàn)對比劑充盈不均或缺損,所有病例達到診斷要求。 結(jié)論： 自然呼吸下高螺距雙源CTPA檢查能得到?jīng)]有呼吸和心臟運動偽影的優(yōu)質(zhì)CTPA圖像,能滿足肺栓塞診斷的要求,對危重、呼吸急促及不能屏氣患者的CTPA檢查特別有價值。而且這種技術(shù)明顯降低輻射劑量及減少碘對比劑的用量。
[Abstract]:Objective:. To evaluate the imaging quality of high pitch dual source CT pulmonary angiography (CTPA) under natural breathing, and to explore the feasibility of using this technique in patients with suspected pulmonary embolism. Methods:. 110 patients with suspected pulmonary embolism were randomly divided into two groups: high pitch group (n = 55) with a pitch of 3.0, tube voltage of 100 KV and tube current of 100 Mas. 40 ml. Routine CTPA was performed in the control group. Pitch pitch was 0.8, tube voltage was 120 KV, tube current was 100 mAs, contrast agent was 80 ml, breath-holding scanning after deep inspiratory. The enhancement degree of pulmonary artery in the two groups was compared and compared, such as the main pulmonary artery, the apical segment S1) and the posterior basal segment S10). Image noise, signal-to-noise ratio (SNR), CT volumetric dose index (CTDIvoll), dose length product (DLPX), effective dose (EDV) and subjective quality rating of image were evaluated by SPSS19.0 software, Student t test and four-grid chart chi-square test. Nonparametric rank sum test (RSR) and Kappa consistency test were used for statistical analysis. Results:. The mean CT value of pulmonary artery trunk in the high pitch group (421 鹵107) was higher than that in the routine group (375 鹵113), the SNRs1(41.63 鹵9.26) and the SNRs10(41.31 鹵9.13 in the high pitch group were significantly higher than those in the routine group (SNRs1, SNRs1o(33.24 10.23 ~ 35.20 鹵11.11). The difference between the two groups was significant (p0.01), the mean image noise was 10.05 鹵1.53 and the mean time of examination was 10.05 鹵1.53. 0.76 鹵0.07) was significantly lower than that in the routine group. The average radiation doses of CTDIvoll DLP and Ed in the high pitch group were 2.88 鹵0.44 mGy / cm and 1.50 鹵0.23 mGy / cm, respectively, which were significantly lower than those in the normal group (5.61 鹵0.98mGy) 144 鹵30mGy / cm and 2.45 鹵0.52mSv.The subjective image quality score of the high pitch group was significantly higher than that of the normal group (p0.05). There were no respiratory and cardiac motion artifacts, no uneven filling or defect of contrast medium, and all patients met the diagnostic requirements. Conclusion:. High pitch dual-source CTPA under natural respiration can obtain high quality CTPA images without respiratory and cardiac motion artifacts, which can meet the requirements of pulmonary embolism diagnosis. CTPA is of particular value in patients with shortness of breath and breath-holding, and this technique significantly reduces the dose of radiation and the dosage of iodine contrast agents.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R816.41

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本文編號：1529977